Strattice is a surgical mesh made from pig skin that has been processed to remove all living cells, leaving behind only the structural protein framework. This framework, called an acellular dermal matrix, acts as a scaffold that your body gradually incorporates into its own tissue. It is FDA-cleared for repairing or reinforcing soft tissue where weakness exists, and it is most commonly used in hernia repair and implant-based breast reconstruction.
How Strattice Is Made
The product starts as porcine (pig) dermis, the thick middle layer of skin rich in collagen. A proprietary process strips away all the cells and, critically, removes the specific biological components most likely to trigger a rejection response. What remains is a collagen-rich sheet that retains the natural architecture of skin but contains no living material. Because no cells are present, the body is far less likely to mount an immune reaction against it compared to an unprocessed animal graft.
Strattice comes in several configurations. A “Firm” version provides more rigidity for abdominal wall repairs, while a “Contoured” version is pre-shaped in a medium curve for breast reconstruction. An extra-thick option is also available for cases requiring additional structural support. All versions are sold sterile and stored at room temperature. Each carton includes a built-in temperature monitor; if the monitor does not read “OK,” the product should not be used.
What Happens After Implantation
Unlike synthetic mesh, which stays in the body as a permanent foreign material, Strattice is designed to be gradually replaced by your own tissue. The process begins quickly. Within about two weeks of implantation, new blood vessels start growing into the matrix, your own cells begin migrating in, and white blood cells appear at the site. By six months, the blood vessel network inside the graft has matured. Over time, the collagen scaffold is broken down and replaced by your body’s own collagen, essentially turning the patch into living tissue rather than a permanent implant.
This remodeling process is the main theoretical advantage over synthetic mesh. A synthetic mesh can erode into surrounding organs, cause chronic pain from stiffness, or become a site for persistent infection because bacteria can colonize the material. A biologic graft like Strattice, because it integrates into native tissue and is eventually replaced, may carry a lower risk of these long-term complications. However, this integration also means the repair may not be as mechanically strong as synthetic alternatives in some situations.
Where Strattice Is Used
The two most common applications are abdominal wall (hernia) repair and breast reconstruction after mastectomy.
- Hernia repair: Strattice is often chosen for complex or contaminated hernias where synthetic mesh would carry a high infection risk. If a hernia repair is being done in a surgical field that is already infected or has a high chance of becoming infected, placing a permanent synthetic mesh can lead to serious complications. A biologic matrix like Strattice gives the surgeon an alternative that can tolerate a contaminated environment better.
- Breast reconstruction: In implant-based breast reconstruction, the surgeon needs something to support and cover the lower portion of the breast implant. Strattice acts as an internal sling, holding the implant in a natural position and providing a layer of tissue between the implant and the skin. This can allow reconstruction to be completed in a single stage rather than requiring a tissue expander first. Strattice was commercially launched in December 2008 and quickly became a widely used option for this purpose.
Its FDA clearance covers use as a soft tissue patch to reinforce weak tissue or to repair damaged or ruptured soft tissue membranes. Some uses that surgeons may attempt, such as reinforcing a stoma (an opening created for a colostomy bag), fall outside the product’s cleared indications in the U.S.
Complication Rates
Strattice is not complication-free. In one retrospective study of hernia repairs using Strattice, the overall hernia recurrence rate was about 21%, meaning roughly one in five patients eventually saw the hernia return on imaging. More than half of the patients in that study (about 55%) experienced some type of wound event within an average follow-up of around 22 months.
The breakdown of those complications gives a clearer picture. Infection occurred in about 31% of patients, skin necrosis (death of overlying skin tissue) in about 14%, wound separation in about 5%, and fluid collection (seroma) in about 2%. These numbers come from complex hernia repairs, which tend to be high-risk cases to begin with. Patients undergoing elective breast reconstruction in a clean surgical field typically face lower complication rates, though infection and seroma remain the most common issues across all applications.
It is worth noting that surgeons often choose Strattice precisely for the most difficult cases, where patients may be obese, have had multiple prior surgeries, or have active wound contamination. The complication rates partly reflect the severity of the cases where biologic mesh is used rather than a shortcoming of the product alone.
How It Compares to Other Options
Strattice sits in a category called biologic mesh, which includes products derived from human cadaver skin (such as AlloDerm), cow tissue, and other porcine sources. The main distinction among porcine products is whether the collagen is chemically cross-linked. Cross-linking makes the material stronger and slower to break down, but it can also impair the body’s ability to remodel and integrate the graft. Strattice is non-cross-linked, meaning it prioritizes tissue integration over raw durability.
Compared to synthetic mesh (made from polypropylene or polyester), biologic options like Strattice are significantly more expensive. The tradeoff is reduced risk of the chronic complications that synthetic mesh is known for: mesh erosion, chronic stiffness, and persistent infection. For straightforward, clean hernia repairs in otherwise healthy patients, synthetic mesh remains the standard. Strattice and other biologic meshes are generally reserved for contaminated fields, high-risk patients, or reconstructive procedures where the properties of a biologic material offer a clear advantage.
What to Expect as a Patient
If your surgeon has recommended Strattice, the product itself does not change much about your surgical experience. It requires no special preparation on your part. In the operating room, the surgical team soaks the sheet in saline for at least two minutes before placing it, and they can trim it to the exact size and shape needed. It is sutured or tacked into place like any other mesh.
Recovery depends on the procedure rather than the mesh material. For hernia repair, you can expect several weeks of activity restrictions. For breast reconstruction, the timeline is similar to any implant-based procedure. Your surgeon may order imaging at follow-up visits to confirm the mesh is integrating properly and that the repair is holding. Because the material is gradually replaced by your own tissue, the long-term goal is a repair that feels and behaves like natural tissue rather than a permanent implant sitting under your skin.